Authors Shalabh Sharma Department of ENT, Sir Ganga Ram Hospital, New Delhi, India - 110060 Satinder Singh Department of ENT, Sir Ganga Ram Hospital, New Delhi, India - 110060 Anandita Gupta Department of ENT, Sir Ganga Ram Hospital, New Delhi, India - 110060 Asish Kumar Lahiri Department of ENT, Sir Ganga Ram Hospital, New Delhi, India - 110060 Meenakshi Wadhera Department of ENT, Sir Ganga Ram Hospital, New Delhi, India - 110060 DOI: https://doi.org/10.3329/bjo.v28i1.60835 Keywords: otosclerosis; hearing loss, sensorineural; cochlear implantation; stapes surgery Abstract

Introduction: Cochlear implantation as well as stapedotomy followed by use of hearing aid are acceptable modes of surgically rehabilitating patients with far advanced otosclerosis. Surgical challenges of CI include difficulties associated with electrode insertion and facial nerve stimulation. Improvement in speech discrimination scores and overall satisfaction with stapedotomy and hearing aid use are reportedly poor in many patients, yet being a low cost procedure it may be used as initial management in a subset of patients.

Case Report: 46 year old patient with diffuse confluent retrofenestral otoscerosis underwent cochlear implantation. He was mapped using behavioral thresholds as despite intracochlear electrode position no neural response was recordable per-operatively as well as in the postoperative period. Perimodiolar electrodes and sodium flouride therapy were used to overcome problems of FNS. 18 months post CI the patient has good audiologic outcomes (CAP 7) without any FNS.

Conclusion: High resolution computed tomography, air bone gap and speech discrimination scores are important in formulating treatment plan in patients with far advanced otosclerosis. Early cochlear implantation can be considered in patients with poor speech discrimination scores and extensive cochlear lesions. Facial nerve stimulation can be prevented by adequate pre-operative planning.

Bangladesh J Otorhinolaryngol 2022; 28(1): 112-117

Downloads

Download data is not yet available.

How to Cite

Sharma, S. ., Singh, S. ., Gupta, A. ., Lahiri, A. K. ., & Wadhera, M. . (2022). Cochlear Implantation in Advanced Otosclerosis: Rising to the Challenges of Surgery and Decision making. Bangladesh Journal of Otorhinolaryngology, 28(1), 112–117. https://doi.org/10.3329/bjo.v28i1.60835

Issue Section

Case Reports

License

Manuscripts submitted for publication in the Bangladesh Journal of Otorhinolaryngology must not have been previously submitted or published. Accepted papers become the permanent property of the Bangladesh Journal of Otorhinolaryngology. By submitting a manuscript, the authors(s) agree that copyrights for their articles are automatically transferred to Bangladesh Journal of Otorhinolaryngology, if and when the articles are accepted for publication.

The use, in this journal, of registered trade names, trade marks, etc. without special acknowledgement does not imply that such names, as defined by the relevant protection laws, be regarded as unprotected, and, thus, free for general use.

Authors who publish with this journal agree to the following terms:

 

Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.

Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.

Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).